Postma, Vickie L. v. Paul Revere Life ( 2000 )


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  • In the
    United States Court of Appeals
    For the Seventh Circuit
    Nos. 99-2627 & 99-2652
    VICKIE L. POSTMA,
    Plaintiff-Appellee,
    Cross-Appellant,
    v.
    PAUL REVERE LIFE INSURANCE COMPANY,
    a Massachusetts corporation,
    Defendant-Appellant,
    Cross-Appellee.
    Appeals from the United States District Court
    for the Northern District of Illinois, Eastern Division.
    No. 95 C 6575--Wayne R. Andersen, Judge.
    Argued February 9, 2000--Decided August 7, 2000
    Before BAUER, EASTERBROOK and RIPPLE, Circuit Judges.
    RIPPLE, Circuit Judge. Vickie Postma injured her
    back while at work for her employer, Computer
    Power Group ("CPG"). She thereafter filed a claim
    for disability benefits with her insurer, Paul
    Revere Insurance Company ("Paul Revere"). Paul
    Revere denied her claim for disability benefits
    and, when she appealed, continued to deny her
    claim despite additional evidence provided by
    her. In response to Paul Revere’s repeated
    refusal to pay disability benefits, Ms. Postma
    filed this action in the district court. The
    district court granted summary judgment for Ms.
    Postma; Paul Revere appeals that decision. For
    the reasons set forth below, we affirm the
    decision of the district court, although on
    alternative grounds.
    I
    BACKGROUND
    A. Facts
    1.
    Ms. Postma began working as a computer
    consultant for the Computer Power Group in 1989.
    As a consultant for CPG, she traveled--by car,
    train, and airplane--to the places of business of
    her clients. The work supplies she brought to her
    clients included boxes of training manuals and
    supplies, reference materials, and reports. Her
    job involved a combination of both light and
    medium lifting: The "light lifting" encompassed
    the frequent lifting and carrying of objects
    weighing between 10 and 20 pounds, and the
    "medium lifting" involved the lifting of
    materials weighing between 25 and 50 pounds.
    R.29, Ex.21 at 6. At her clients’ work sites, she
    sometimes needed to carry these boxes up and down
    stairs. Ms. Postma’s job duties also required her
    to walk and to stand for significant periods of
    time. Some days, she reported, she needed to
    stand between 8 and 9 hours.
    While at CPG, Ms. Postma enrolled in a long term
    disability insurance program provided by Paul
    Revere.
    2.
    Ms. Postma, while traveling to visit a client on
    October 2, 1991, boarded a train and injured her
    back when she tried to lift her briefcase. She
    consulted a chiropractor, but her condition did
    not improve. She then visited an orthopedic
    surgeon who diagnosed a herniated lumbar disc.
    This physician performed surgery, but Ms. Postma
    continued to experience pain, and she did not
    return to work at CPG.
    On April 9, 1992, CPG terminated Ms. Postma. It
    had held her position open for the six-month
    medical leave period required by company policy
    and then, because she had not returned to work,
    discharged her.
    Ms. Postma then visited a different orthopedic
    surgeon, Dr. Gutierrez. He diagnosed a recurrent
    herniated lumbar disc and performed a second
    surgery. After this surgery, she did not report
    feeling pain. On September 9, 1992, Dr. Gutierrez
    released Ms. Postma to return to work but placed
    restrictions on her work activities. She then
    attempted to find a position with a different
    employer that involved the same duties as her
    position at CPG but that could accommodate her
    medical restrictions. Even though she sent over
    500 resumes to different companies and
    interviewed over 15 times, she did not secure
    employment.
    In March, Ms. Postma again visited Dr.
    Gutierrez; however, this visit stemmed from neck
    pain she was experiencing. At that time, he
    reported that she was not suffering pain in her
    back. He also advised her to return to him on an
    "as needed" basis. R.35, Ex.F at 22.
    Starting on April 26, 1993, and continuing until
    June 11, 1993, Ms. Postma worked for Highland
    Park Animal Hospital as a veterinary assistant.
    While at the animal hospital, she worked subject
    to Dr. Gutierrez’s restrictions. On June 12,
    however, she was admitted to a hospital for
    reinjuring her initial back injury. After this
    date, Ms. Postma’s back injury again prevented
    her from returning to work at all.
    Later that year, Ms. Postma notified Paul Revere
    that she intended to file a claim for disability
    benefits. She thereafter submitted to Paul Revere
    her medical records, which included Dr.
    Gutierrez’s attending physician statement. Dr.
    Gutierrez’s statement indicated that Ms. Postma
    had been unable to work in her occupation at CPG
    from October 1991 to October 1993 (the date of
    his statement).
    After reviewing Ms. Postma’s file, Paul Revere
    denied her claim for disability benefits because
    it opined that (1) her injury did not prevent her
    from performing her previous occupation’s
    important duties, (2) she was not under the
    regular care of a physician, and (3) her
    termination from CPG ended its obligation to pay
    her benefits. She appealed Paul Revere’s initial
    decision. In the process, she submitted the
    deposition of her manager at CPG, John Kinstler,
    which stated that her medical restrictions
    prevented her from fulfilling her job duties.
    Paul Revere, however, again denied Ms. Postma’s
    claim for benefits.
    Ms. Postma later received disability benefits
    from the Social Security Administration and
    settled her worker’s compensation award. Both of
    these decisions and the evidence supporting them
    were provided to Paul Revere; however, it
    continued to deny her claim for benefits.
    B.   Proceedings in the District Court
    Ms. Postma then filed this action against Paul
    Revere for breach of contract and for breach of
    the implied covenant of good faith and fair
    dealing. She requested a declaratory judgment
    that Paul Revere must pay her benefits, and she
    requested attorney’s fees.
    The district court held that Ms. Postma was
    entitled to benefits for total disability from
    October 2, 1991, (the date of her initial injury)
    to April 26, 1993, (the date she started working
    at the animal hospital)./1 Also, it stated that
    she was under a residual disability from April
    26, 1993, to June 11, 1993, while she worked at
    the animal hospital. Finally, the court
    determined that she was totally disabled again
    following June 11, 1993 (the date she reinjured
    her back).
    II
    DISCUSSION
    A. Standard of Review
    1.
    The parties dispute whether Paul Revere’s long
    term disability ("LTD") plan is governed by the
    Employee Retirement Income Security Act of 1974
    ("ERISA"), 29 U.S.C. sec. 1000 et seq. Ms. Postma
    argues that the insurance policy was not an ERISA
    plan and that we therefore should review Paul
    Revere’s decision to deny her benefits de novo.
    The district court held, however, that the policy
    was an ERISA plan.
    The district court’s finding that this plan is
    an ERISA plan is a finding of fact that is
    reversed only if it is clearly erroneous. See
    Zavora v. Paul Revere Life Ins. Co., 
    145 F.3d 1118
    , 1120 (9th Cir. 1998). We previously have
    explained that a welfare plan requires five
    elements:
    (1) a plan, fund, or program, (2) established or
    maintained, (3) by an employer or by an employee
    organization, or by both, (4) for the purpose of
    providing medical, surgical, hospital care,
    sickness, accident, disability, death,
    unemployment or vacation benefits, apprenticeship
    or other training programs, day care centers,
    scholarship funds, prepaid legal services or
    severance benefits, (5) to participants or their
    beneficiaries.
    Ed Miniat, Inc. v. Globe Life Ins. Group, Inc.,
    
    805 F.2d 732
    , 738 (7th Cir. 1986).
    According to the district court, the parties
    here dispute only whether the plan was
    "established or maintained" by "an employer."
    R.52 at 8. An employer establishes or maintains a
    plan if it enters a contract with the insurer and
    pays its employees’ premiums. See Brundage-
    Peterson v. Compcare Health Serv. Ins. Corp., 
    877 F.2d 509
    , 511 (7th Cir. 1989). To help determine
    whether an insurance plan falls under ERISA, the
    Department of Labor’s regulations, through a
    "safe harbor" provision, provide a guideline for
    when a plan does not fall under ERISA. The
    regulation that Ms. Postma claims is applicable
    to her case is the following:
    (j) Certain group or group-type insurance
    programs. For purposes of Title I of the Act and
    this chapter, the terms "employee welfare benefit
    plan" and "welfare plan" shall not include a
    group or group-type insurance program offered by
    an insurer to employees or members of an employee
    organization, under which
    (1) No contributions are made by an employer or
    employee organization;
    (2) Participation in the program is completely
    voluntary for employees or members;
    (3) The sole functions of the employer or employee
    organization with respect to the program are,
    without endorsing the program, to permit the
    insurer to publicize the program to employees or
    members, to collect premiums through payroll
    deductions or dues checkoffs and to remit them to
    the insurer; and
    (4) The employer or employee organization receives
    no consideration in the form of cash or otherwise
    in connection with the program, other than
    reasonable compensation, excluding any profit,
    for administrative services actually rendered in
    connection with payroll deductions or dues
    checkoffs.
    29 C.F.R. sec. 2510.3-1(j). This court has held
    that "[a]n employer who creates by contract with
    an insurance company a group insurance plan and
    designates which employees are eligible to enroll
    in it is outside the safe harbor created by the
    Department of Labor regulation." Brundage-
    
    Peterson, 877 F.2d at 511
    . In Brundage-Peterson,
    we also explained that, when the employer helps
    defray the cost of the employee’s insurance, it
    is even clearer that the plan falls outside of
    the safe harbor. See 
    id. The district
    court determined that the plan at
    issue here did not fit within the Department of
    Labor regulations’ safe harbor. Although the
    employees at CPG originally covered the costs of
    the LTD policy, CPG made LTD benefits a standard,
    rather than optional, benefit for all employees
    in February 1992 and thus began paying the
    premiums. The court also explained that, because
    CPG purchased the plan and offered it to its
    employees and because it started paying the
    premiums while Ms. Postma was still an employee
    (although on medical leave at the time), CPG
    established or maintained the benefit plan. The
    court’s finding that CPG maintained its benefit
    plan for its employees is not clearly erroneous.
    CPG did pay its employees’ premiums while Ms.
    Postma was still an employee. Moreover, CPG began
    these payments before she made her claim for
    benefits to Paul Revere. We note, further, that,
    throughout its existence, the disability policy
    was part of a broader benefits package maintained
    by CPG for its employees. Many aspects of that
    plan were financed in whole or in part by CPG.
    For purposes of determining whether a benefit
    plan is subject to ERISA, its various aspects
    ought not be unbundled. See Gaylor v. John
    Hancock Mut. Life Ins. Co., 
    112 F.3d 460
    , 463
    (10th Cir. 1997); Glass v. United of Omaha Life
    Ins. Co., 
    33 F.3d 1341
    , 1345 (11th Cir. 1994);
    Smith v. Jefferson Pilot Life Ins. Co., 
    14 F.3d 562
    , 567 (11th Cir. 1994). We note, moreover,
    that CPG "performed all administrative functions
    associated with the maintenance of the Policy,"
    and that, consequently, "CPG employees received
    discounts on the policy premiums by virtue of the
    fact that they were involved in a group policy
    through CPG." R.28 at 4. See New England Mut.
    Life Ins. Co. v. Baig, 
    166 F.3d 1
    , 4 (1st Cir.
    1999) (stating that "finding [an ERISA] plan
    requires that the employer have at least some
    minimal, ongoing administrative scheme or
    practice" (citations and quotation marks
    omitted)). Therefore, we uphold the district
    court’s finding that the Paul Revere insurance
    plan is subject to ERISA.
    2.
    Having decided that Paul Revere’s LTD plan is
    subject to ERISA, we now must decide the
    appropriate standard for reviewing Paul Revere’s
    decision to deny benefits. The Supreme Court set
    forth the applicable basic rule in Firestone Tire
    & Rubber Co. v. Bruch, 
    489 U.S. 101
    (1989). In
    Firestone, the Court explained that de novo
    review of an ERISA plan administrator’s
    determination to deny benefits is the default
    rule "unless the benefit plan gives the
    administrator or fiduciary discretionary
    authority to determine eligibility for benefits
    or to construe the terms of the plan." 
    Id. at 115.
    "Where a plan confers discretionary power on
    the plan administrator, the deferential
    ’arbitrary and capricious’ standard governs."
    Wilczynski v. Kemper Nat’l Ins. Cos., 
    178 F.3d 933
    , 934 (7th Cir. 1999); see also Ross v.
    Indiana State Teacher’s Ass’n Ins. Trust, 
    159 F.3d 1001
    , 1008-09 (7th Cir. 1998), cert. denied,
    
    119 S. Ct. 113
    (1999); Hightshue v. AIG Life Ins.
    Co., 
    135 F.3d 1144
    , 1147 (7th Cir. 1998).
    To determine whether a plan grants its
    administrator discretion, we must look to the
    language of the plan. See Herzberger v. Standard
    Ins. Co., 
    205 F.3d 327
    , 329 (7th Cir. 2000);
    Trombetta v. Cragin Fed. Bank for Sav. Employee
    Stock Ownership Plan, 
    102 F.3d 1435
    , 1437-38 (7th
    Cir. 1996). Ms. Postma claims that the policy did
    not reserve discretion in Paul Revere because the
    contract defined "disability" objectively. The
    district court, however, determined that the plan
    granted Paul Revere discretion. We review the
    district court’s determination de novo. See
    
    Hightshue, 135 F.3d at 1147
    . Because we do not
    believe that the plain language of the plan
    grants discretion to Paul Revere as its
    administrator, we cannot accept the district
    court’s determination and, therefore, hold that
    the appropriate standard of review is de novo.
    According to the plan, for a claimant to show
    that she is disabled, she must provide proof that
    she is receiving a doctor’s care. The plan states
    in relevant part:
    Totally disabled from your own occupation or
    total disability from your own occupation means:
    1. because of injury or sickness, you cannot
    perform the important duties of your own
    occupation;
    2. you are receiving Doctor’s Care. We will waive
    this requirement if we receive written proof
    acceptable to us that further Doctor’s Care would
    be of no benefit to you; and
    3. you do not work at all.
    R.6, Ex.A at 13 (emphasis added). The district
    court concluded that the ability of Paul Revere
    to waive the requirement of a doctor’s care, if
    it received proof "acceptable to us," granted
    Paul Revere discretion to interpret the entire
    policy. However, a claimant does not need to
    submit proof acceptable to Paul Revere unless she
    is seeking a waiver. In this context, the
    "acceptable to us" language certainly does not
    inform a reasonable reader of the Paul Revere
    policy that the administrator has discretion on
    the ultimate issue of whether a claimant is
    disabled. Indeed, the placement of such language
    only in the waiver provision makes such a reading
    of the entire disability provision so awkward as
    to be implausible. A determination by an insurer
    that an element of disability may be waived
    differs fundamentally from a finding that the
    requirements necessary to qualify for disability
    have been satisfied. The waiver provision is
    applicable to only one of the three requirements
    for a disability. If a claimant satisfies all
    three requirements for disability, she does not
    even need to seek Paul Revere’s approval for a
    waiver. Therefore, because the language granting
    discretion is only in the clause pertaining to a
    waiver, we must consider this language
    insufficient to grant the administrator
    discretion.
    The district court also noted that the plan
    requires a claimant to provide medical evidence
    acceptable to Paul Revere to prove eligibility
    for insurability. As the plan states, "EVIDENCE OF
    INSURABILITY means proof given to us that an employee
    is insurable. This proof must be based on medical
    information and must be acceptable to us." R.6,
    Ex.A at 3. Eligibility for insurance, however,
    clearly is distinguishable from eligibility for
    benefits. Once the claimant submits proof of
    eligibility for insurance and the administrator
    determines that she is eligible, the
    administrator does not have discretion, based on
    that provision, to deny benefits. The two
    provisions are completely separate, and we hold
    that the discretion to determine eligibility for
    insurance does not grant the administrator
    discretion to determine eligibility for benefits.
    Finally, Paul Revere argues that language in the
    plan pertaining to the proof of loss that a
    claimant must submit to Paul Revere is sufficient
    to grant Paul Revere discretion in determining
    whether to grant benefits. The relevant language
    states: "Written proof should establish facts
    about the claim such as occurrence, nature and
    extent of the disability, injury or sickness or
    the loss involved." R.6, Ex.A at 39. Also, "[w]e
    have the right to require additional written
    proof to verify the continuance of any
    disability. We may request this additional proof
    as often as we feel is necessary, within reason."
    
    Id. at 40.
    Finally, the plan explains that "[w]e
    have the right to require written proof of
    financial loss. This includes, but is not limited
    to: . . . any other proof we may reasonably
    require. . . . Payment of benefits may be
    contingent upon receipt of satisfactory proof of
    financial loss." 
    Id. at 41.
    "Proof of loss" language is standard insurance
    contract language. See 
    Herzberger, 205 F.3d at 332
    . It does not automatically grant discretion;
    instead, it is the means by which the claimant
    submits a claim to the insurer. As this circuit
    recently held, language pertaining to "proof of
    loss," without more, is insufficient to confer
    discretion. See 
    id. In Herzberger,
    the two ERISA
    plans used language such as "determine," "proof,"
    and "satisfactory proof." We held that
    the mere fact that a plan requires a
    determination of eligibility or entitlement by
    the administrator, or requires proof or
    satisfactory proof of the applicant’s claim, or
    requires both a determination and proof (or
    satisfactory proof), does not give the employee
    adequate notice that the plan administrator is to
    make a judgment largely insulated from judicial
    review by reason of being discretionary.
    
    Id. Paul Revere’s
    LTD plan does not contain any
    language, independent of typical policy terms
    that require proof of disability, to indicate
    that it intended to reserve discretion in itself.
    We therefore conclude that the proof of loss
    language in this policy does not confer
    discretion on Paul Revere.
    Because Paul Revere’s insurance plan does not
    grant Paul Revere the discretion to determine a
    claimant’s eligibility for benefits, we conclude
    that the appropriate standard for our review of
    Paul Revere’s decision to deny benefits is de
    novo.
    B.   The Disability Claim
    The question remains whether Paul Revere
    correctly denied Ms. Postma’s application for
    disability benefits. The district court,
    employing the more deferential arbitrary and
    capricious standard of review, refused to uphold
    Paul Revere’s decision to deny Ms. Postma
    disability benefits. Although we disagree with
    the district court’s determination on the
    appropriate standard of review, we uphold the
    grant of summary judgment for Ms. Postma because
    it is clear that, when the appropriate de novo
    standard is employed, she has presented
    sufficient proof of her disability and,
    therefore, that she is entitled to disability
    benefits from Paul Revere.
    1.
    Paul Revere’s LTD policy states that, to be
    totally disabled, the claimant must show:
    1. because of injury or sickness, you cannot
    perform the important duties of your own
    occupation;
    2. you are receiving Doctor’s Care. We will waive
    this requirement if we receive written proof
    acceptable to us that further Doctor’s Care would
    be of no benefit to you; and
    3. you do not work at all.
    R.6, Ex.A at 13. Ms. Postma clearly met the
    requirements for total disability after she
    injured her back: She was unable to work at all
    and therefore unable to perform the important
    duties of her occupation. Once Dr. Gutierrez
    released her to return to work, however, the
    provision for total disability no longer applied.
    The existence of the work release indicated that,
    as of September 9, 1992, Ms. Postma could perform
    at least some, although not all, of the duties of
    her occupation.
    The applicable provision for Ms. Postma then
    became the clause for residual disability. The
    policy explains the requirements for residual
    disability as follows:
    Residually disabled or residual disability means,
    after a continuous period of disability which
    lasts at least as long as your elimination
    period[/2]:
    1. (A) you are prevented, by the same injury or
    sickness which caused your disability, from
    performing one or more of the important duties of
    your own occupation; or
    (B) you work at your own or some other occupation
    on less than a full-time basis; and
    2. you are receiving Doctor’s Care. We will waive
    this requirement if we receive written proof
    acceptable to us that further Doctor’s Care would
    be of no benefit to you; and
    3. you do not earn more than 80% of your prior
    earnings.
    R.6, Ex.A at 14. Although Paul Revere admits that
    Ms. Postma was totally disabled until she
    received her work release, it claims that her
    work release demonstrates that she was no longer
    disabled./3 Ms. Postma did not meet the
    requirements for total disability after her work
    release, but the question remains whether she met
    the requirements for residual disability. As long
    as Ms. Postma was continuously disabled--either
    totally or residually--between her work release
    (September 9, 1992) and the date she reinjured
    her back (June 11, 1993), when she again could
    not work at all, she is entitled to disability
    benefits for the entire time following her
    initial back injury.
    Ms. Postma may satisfy the first element for
    residual disability by showing that she cannot
    perform one or more of the important duties of
    her occupation at CPG. As a consultant for CPG,
    Ms. Postma had traveled by car, train, and
    airplane to her clients’ businesses carrying
    boxes of supplies. She frequently had to lift
    materials weighing between 10 and 20 pounds and
    often had to lift materials weighing between 25
    and 50 pounds. Her job duties also had required
    her to walk and to stand for significant periods
    of time. Some days, she reported, she needed to
    stand between 8 and 9 hours. The staffing manager
    at CPG, John Kinstler, also explained that, as
    part of her job responsibilities, Ms. Postma
    regularly had to lift objects that weighed more
    than 10 pounds, to drive for over 30 minutes, to
    kneel, to squat, and to bend. Dr. Gutierrez’s
    work release for Ms. Postma listed the activities
    that she could not perform, including: not
    lifting more than 10 pounds, not driving for more
    than 30 minutes, not twisting, not squatting, not
    bending, not kneeling, and not doing any other
    physical activity that could injure her back.
    Kinstler explained that these medical
    restrictions prevented Ms. Postma from performing
    her job responsibilities./4 Thus, due to her
    medical restrictions, we must conclude that Ms.
    Postma was unable to perform one or more of the
    important duties of her occupation at CPG even
    after her work release and even after she began
    working at the animal hospital.
    After Ms. Postma found employment at the animal
    hospital, she worked subject to Dr. Gutierrez’s
    medical restrictions. These medical restrictions
    again demonstrate that she was prevented by her
    back injury from performing one or more of the
    important duties of her occupation at CPG. Dr.
    Gutierrez’s attending physician statement further
    clarified that Ms. Postma was unable to perform
    her occupation at CPG from October 1991 (the date
    of her initial injury) through October 1993 (the
    date of his report after her reinjury).
    Therefore, Ms. Postma satisfies the first element
    of residual disability beginning on the date of
    her work release and continuing until she
    reinjured her back.
    The next element that Ms. Postma must satisfy is
    the requirement that she receive a doctor’s care.
    The policy defines doctor’s care as "the regular
    and personal care of a Doctor which under
    prevailing medical standards, is appropriate for
    the condition causing the disability." R.6, Ex.A
    at 15. Dr. Gutierrez stated that he provided the
    appropriate doctor’s care for Ms. Postma’s back
    injury, and, because Paul Revere did not provide
    evidence to show that Dr. Gutierrez’s care did
    not meet prevailing medical standards, we hold
    that she was under a doctor’s care and that she
    satisfies this element for disability.
    Finally, Ms. Postma must have earned less than
    80% of her original income at CPG. While she was
    seeking employment after she received her work
    release, Ms. Postma clearly made less than 80% of
    her prior income because she did not work at all.
    Also, after she began working at the animal
    hospital, the parties do not dispute that she
    received less than 80% of the income she received
    while employed as a consultant for CPG. Thus, she
    meets the final element of residual disability
    under the policy.
    Because Ms. Postma can satisfy the plan’s
    requirements for residual disability from the
    time of her work release on September 9, 1992,
    until her reinjury on June 11, 1993, and, because
    Paul Revere concedes that she can meet the
    elements of total disability from October 2,
    1991, to September 9, 1992, and again after June
    11, 1993, we hold that Ms. Postma should be
    awarded disability benefits.
    C.   Attorneys’ Fees
    Having determined that the plaintiff’s action
    was governed by ERISA, the district court
    correctly acknowledged that it had discretion to
    award attorneys’ fees to the prevailing party.
    See 29 U.S.C. sec. 1132(g); see also Trustmark
    Life Ins. Co. v. University of Chicago Hosp., 
    207 F.3d 876
    , 884 (7th Cir. 2000). We also believe
    that the district court was correct in its
    determination that, although Ms. Postma did not
    prevail on the threshold question of ERISA
    preemption, she did prevail on the ultimate
    question of whether she was owed disability
    payments from Paul Revere. Therefore, she should
    be considered the "prevailing party" for the
    purpose of awarding attorneys’ fees. There is a
    "modest presumption" that a prevailing party is
    entitled to her attorneys’ fees; however, "a
    court may decline to award fees and costs if it
    finds that: (1) the losing party’s position had a
    reasonable or solid basis in law and facts; or
    (2) special circumstances make an award unjust."
    Harris Trust & Sav. Bank v. Provident Life &
    Accident Ins. Co., 
    57 F.3d 608
    , 617 (7th Cir.
    1995) (citations and quotation marks omitted). We
    cannot say that the district court abused its
    discretion in concluding that Paul Revere’s
    denial of benefits was not substantially
    justified under the law as applied to the facts
    of this case. See Production & Maintenance
    Employees’ Local 504 v. Roadmaster Corp., 
    954 F.2d 1397
    , 1405 (7th Cir. 1992)./5 Accordingly,
    we shall not disturb its judgment in this regard.
    Conclusion
    For the foregoing reasons, we affirm the
    decision of the district court to grant Ms.
    Postma’s motion for summary judgment. Ms. Postma
    may recover her costs in this court. Ms. Postma
    also may recover her attorneys’ fees for this
    appeal by filing with the district court a
    statement of reasonable attorneys’ fees within 14
    days of the issuance of this court’s mandate.
    AFFIRMED
    /1 The district court, in its initial order,
    identified the applicable dates as October 2,
    1991, and April 26, 1993. However, in its
    subsequent order, without explanation, it used
    the dates of October 1, 1991, and April 27, 1993.
    Because both the parties and the record indicate
    that the dates of October 2, 1991, and April 26,
    1993, are the correct dates, we shall use those
    dates as the applicable ones.
    /2 An elimination period is the length of time a
    claimant must wait before benefits begin. Ms.
    Postma’s elimination period was 90 days. There is
    no dispute that she was continuously disabled for
    the 90 days of her elimination period.
    /3 Paul Revere also argues that Ms. Postma’s
    disability benefits should have ceased as soon as
    she was terminated by CPG. However, the policy
    clarifies that, as long as a claimant’s
    disability continues, she is entitled to
    benefits. Because we hold that Ms. Postma was
    disabled continuously by her back injury, from
    October 1991 until at least the time when she
    filed this lawsuit, her benefits continued
    despite the fact that she no longer worked for
    CPG. If insurance benefits ended as soon as a
    claimant stopped working for her original
    employer, then the residual disability provision,
    which allows the disabled claimant to work at a
    different job and still receive benefits, would
    be superfluous.
    /4 Although Kinstler stated that CPG would have been
    willing to provide accommodations for Ms.
    Postma’s medical restrictions, he also admitted
    that CPG would need to consult with the clients
    Ms. Postma would work with before it could commit
    to accommodating her restrictions because her
    accommodations would require assistance from her
    clients. He also conceded that some clients might
    not want to assist CPG and Ms. Postma in
    accommodating her.
    /5 The district court also acknowledged that our
    circuit on occasion has employed another test:
    (1) the degree of the offending parties’
    culpability or bad faith; (2) the degree of the
    ability of the offending parties to satisfy
    personally an award of attorneys’ fees; (3)
    whether or not an award of attorneys’ fees would
    deter other persons acting under similar
    circumstances; (4) the amount of benefit
    conferred on members of the [benefits] plan as a
    whole; and (5) the relative merits of the
    parties’ positions.
    Harris 
    Trust, 57 F.3d at 616
    n.5.